Hormonal changes during menopause mnemonic

Short post for the day! :)

"EPIc FALL"
- Estrogen
- Progesterone
- Inhibin
levels Fall during menopause.

Estrogen and osteoporosis

Lack of estrogen causes a decrease in osteoprotegerin.

Osteoprotegerin (OPG), also known as osteoclastogenesis inhibitory factor (OCIF), is a cytokine and a member of the tumor necrosis factor (TNF) receptor superfamily.

Osteoprotegerin inhibits the differentiation of macrophages into osteoclasts and also regulates the resorption of osteoclasts.
Mnemonic: Osteoprotegerin protects bone (By preventing macrophage differentiation into osteoclasts.)

Osteoprotegerin, a RANK homolog, works by binding to the RANK-ligand on Osteoblast/Stromal cells, thus blocking the RANK-RANK lingand interaction between Osteoblast/Stromal cells and Osteoclast precursors. This has the effect of inhibiting the differentiation of the Osteoclast Precursor into a mature Osteoclast.
Mnemonic: Osteoprotegerin ranks high in protecting bones.

So, estrogen kinda inhibits the osteoclasts which causes osteoporosis is the moral of the story?

Yep.

Extra: Recombinant human osteoprotegerin specifically acts on bone, increasing bone mineral density and bone volume. Osteoprotegerin has been used experimentally to decrease bone resorption in women with postmenopausal osteoporosis and in patients with lytic bone metastases.

That's all!

-IkaN

Submissions: Chagas disease notes

Here are some beautifully presented points on Chagas disease written by Jolhf Mathai Koshy.

I didn't know about Romanas sign and Chagomas.

The MEGA mnemonic for cardiomegaly, splenomegaly, megaeosophagus and megacolon is brilliant.

Now, my brain is swollen up with sweet information! Thanks a lot, Jolhf!

-IkaN

Related post: Study group discussion on Chagas disease

Whipples disease mnemonic

Mini post of the day!

Whipples disease responds to antibiotics like ceftriaxone and TMP-SMX.

"Whip Whipples with antibiotics."

W: Caused by T. Whippleii
Hip: Reminds me of arthralgias
P: For PAS positive macrophages
L: Lymphadenopathy
E: Eye findings

Celiac disease mnemonic

Hello. Something about celiac disease today!

"In celiac disease, the gut is cealed (sealed) with GLUe."

Study group discussion: Kimmelstiel-Wilson in medicine

Review - How do KW lesions, disease and syndrome differ from each other?

KW lesions refer to nodular glomerulosclerosis - the KW nodules

KW syndrome is nephrotic syndrome developing due to the lesions.

KW disease refers to any other manifestations occurring due to the lesions.

Any other manifestations like?

Manifestations of glomerulonephropathy. I guess hematuria, anasarca, uremia and others.

Study group discussion: Questions on tuberculosis

20 year old girl with a TB contact history comes to OPD with complaint of hemoptysis. Her TST is 20mm and her smear & culture is positive for mycobacterium TB.

Now some questions related to pulmonary TB!

What is brocks syndrome?

When the enlarging hilar lymph node causes collapse of bronchi, leading to bronchiectasis is called Brocks syndrome. Specially right middle lobe.

What do you exactly mean by post primary tuberculosis?

Post primary refers to TB that occurs few weeks after primary TB when the immunity has developed.

Chemoprophylaxis with which drug should be prescribed if a patient is gonna undergo some immunity wrecking thing like eg, gonna take long term steroids and their CXR shows evidence of previous TB?

Isoniazid.

Breech mnemonic

Hello!

So today, I forgot the types of breech.

And that's why, I made a illustration with eh mnemonic.

There are two types of full breech:
- Complete breech
- Frank breech

There are many types of incomplete breech:
- Footling
- Kneeling

That's all!

-IkaN

Study group discussion: Kochs contact

Question: Definition of Koch's contact!

Answers, comments posted on the group -

1. Should have:
Sputum positive pulmonary tuberculosis or sputum negative culture positive pulmonary TB

2. Person who is open case of Koch, person who just started AKT and person who completed AKT within 2 years.

Extras:

It was my pediatrics viva question. I didn't know the answer back then! Thanks!

The contact should be a member of the household or be frequenting regularly.

The first identified case in a household is called as index case.

Nitroglycerin

Here are some facts about nitrates!

The prototype drug is nitroglycerin. Other nitrates are isosorbide mononitrate and isosorbide dinitrate.

Nitroglycerin taken sublingually bypasses the first pass metabolism of liver and acts quickly. That is why, it is preferred in termination of an acute attack of angina where a rapid action is needed.

Nitroglycerin in low doses, causes venodilation, decreasing preload. In higher doses, it causes arterial and venous dilation, causing a decrease in preload and afterload.

Repeated and frequent exposure causes tissue tolerance to nitrates. That is why, nitrate free interval is recommended daily, especially with the use of transdermal patches or ointment.

Side effects of nitroglycerin are headache, postural hypotension and reflex tachycardia.

Supraventricular tachycardia mnemonic

To remember about SVT, all you need to remember is the cause and you know the symptoms and treatment!

Internship diaries: Gamjee roll

Attending, burns ward: Bring the *list of things* and a Gamjee along and come for dressing x patient.

Me: What?! Gamjeee?

*inner me*: Samwise Gamgee :D

Study group discussion: Differentials of wasting of small muscles of the hand

What are causes of wasting of small hand muscles?

The approach is to start with the spinal cord and move towards the muscles.

Spinal cord

Syringomyelia
Cervical spondylitis with compression of c8 root segment
Tumour
Trauma

Anterior horn

Motor neuron disease
Polio
Spinal muscular atrophy

Root lesion

C8 compression

Lower trunk brachial plexus

Thoracic outlet syndrome
Trauma, radiation, infiltration, inflammation

Peripheral nerve

Median and ulnar nerve lesion
Peripheral motor neuropathy

Myopathy

Distal myopathy
Dystrophia myotonica

Trophic disorder

Arthripathies
Ischaemia including vasculitis
Shoulder hand syndrome

That's a long list!

You're right. The most important thing is to remember the categories and some of the more common things listed.

Yup I love the way you listed it out.